DeltaCare

DeltaCare^® is a dental HMO that offers maximum cost savings for employers and enrollees while assuring quality controls. The DeltaCare network has dentists practicing in over 87,500 locations nationwide.

Click on the links below to view the documents:

• Encounter form
• Specialty listing
• DeltaCare specialty referral form
  • This referral form is for DeltaCare primary dentists to use to refer a DeltaCare member to a DeltaCare specialty dentist. The DeltaCare specialty listing can be accessed through the Specialty Listing link above. 
• DeltaCare specialty claim form

  • This claim form is for DeltaCare specialty claims. DeltaCare specialists submit claim forms for DeltaCare patients.

DeltaCare Electronic Claim Submissions

Electronic Claim Submission (ECS) is now available for your monthly Delta Care utilization/encounter submissions!*   

Learn more